A significant number of fathers -- about 10 percent -- experience prenatal or postpartum depression, according to a new analysis published in the current edition of the Journal of the American Medical Association.

"There is a clear and consistent link between father's depression and mother's depression," said lead study author James F. Paulson, a clinical psychologist and researcher at the Eastern Virginia Medical School in Norfolk.

Among the other conclusions: Depressive symptoms in either parent could trigger more severe illness in the other.

"We don't know if dad's depression comes first or if there's some other factor, such as colic, crying or the child's health problems that may affect both parents and expose them to increased risk of depression," Paulson said.

The percentage of new dads with depression was the highest among those with 3- to 6-month-old babies, the researchers found.

Maternal malady

Baby-related depression is viewed as a disorder of motherhood, with hormonal changes in women often considered the sole or primary cause. It's been widely concluded that children tend to suffer in a number of ways when new mothers experience everything from baby blues to mental health illnesses including depression, postpartum psychosis and postpartum obsessive compulsive disorder.

Much less is known about how "daddy depression" might influence the mother's mental health or outcomes for children.

Along with other researchers, Paulson examined 43 studies involving 28,000 participants. They found that U.S. fathers had a higher rate of depression -- 14 percent -- versus 8 percent for dads abroad. New and expectant dads in the United States had depression at twice the rate of the general male population. The findings are published in a special JAMA edition focusing on mental health.

"This article is really extraordinary because it highlights that this is a real issue that nobody's been paying attention to," said Dr. Lucy Puryear, a Houston psychiatrist who focuses on women's reproductive mental health.

She's among the best-known Houston experts on postpartum depression, but she says she has treated few male patients.

In 15 years, Puryear said, her only case was a father diagnosed with postpartum obsessive compulsive disorder who had "horrifying intrusive thoughts" that he was going to drop the baby down the stairs.

"Having a baby is a great psychological transition that can bring great joy and great stress for some people that can transform into depression," Puryear said. "Excessive worry gets turned up way too high and it gets out of control and becomes an illness."

Puryear, also an assistant professor at Baylor College of Medicine and the president-elect of Postpartum Support International, a nonprofit organization whose mission is to promote awareness, prevention and treatment of mental health issues related to childbearing. said she found the correlation between postpartum depression in mothers and the likelihood for fathers particularly interesting.

'Whole burden'

"They feel very alone and isolated when their wife is ill and they're worried about the child," she said. "The whole burden is on him and it makes sense to me that a man whose wife has postpartum depression is more vulnerable to having depression himself."

Houston family therapist Sherry Duson recalled a first-time father in his mid-40s who suddenly felt "super-stressed-out" at work because of the recent financial meltdown -- her lone male case of baby-related depression in the last few years.

"Most men don't want to come forward and even talk about it," she said.

There's a social stigma attached to seeking help, too. Sometimes, tag-along ds will pipe up during their wives' postpartum depression support groups and "a lot of times they're talking about their own stress, not just their wives'," Duson said.

Paulson suggests that local practitioners create ways to screen fathers for depression, though he admits that's difficult when dads are less present at prenatal and well baby appointments. He said his next research endeavor involves exploring what's happening in a new baby's family when both parents are depressed.

cindy.george@chron.com

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